Health care is undergoing enormous change again and it’s far from complete. Industry senior executives who led their hospitals through the transition to the Federal DRG system in 1982 acknowledge that change from the Affordable Care Act is substantially greater. The full impact of the employer and individual mandates is still evolving and the Cadillac […]
The next generation of revenue cycle tools should help you tackle today’s problems and speak directly to a vastly different landscape, but will deliverables meet expectations? Much of the revenue cycle is evolving. ICD-10 is here, but it’s much too early to know how this affects receivables, physician productivity, coders, patient engagement, and patient satisfaction. […]
It’s here. The feds, states, and even some insurers (the Big Three) are piling on. Consumers can’t make sense of hospital pricing they claim. You know achieving true pricing transparency is difficult because of third party involvement in health care. The charge master is complicated in part because of this unique construct. Let’s face it […]
All businesses need to create goals, establish priorities, and flesh-in a pathway forward as part of a business plan. Most organizations engage in a purposeful examination of performance (results), structure, markets served, potential new opportunities, positives, negatives, and anything else germane to strategic planning and positioning. Who is your organization (not what)? What are your […]
You are coping with enormous change, including the reality that in many cases you have to do more to receive the same amount of revenue. The delay of the individual and employer mandates delayed some of this, but the new reality of high deductible plans, skinny insurance, narrow networks, and growing bad debt is here. […]
Hospital senior executives see the continuing migration of services from the inpatient to outpatient setting. Growing outpatient services and profit margins naturally follow as a primary focus. CMS continues to push population health ACO’s, even extending the safe period which minimizes potential hospital losses. Embracing population health is another natural key focus. Entrepreneurial health […]
The accelerated push by CMS for greater pricing transparency in our industry may have caused some of us to overlook immediate opportunities. The advent of big data analytics validates the power of statistics. We’ve known this for years, having used an algorithm to help clients produce much more net revenue year-after-year. Is there another significant […]
Reducing costs without growing top-line net revenue only works for awhile. It’s not easy to generate new top-line net revenue in an age of higher patient deductibles, skinny insurance plans, reduced Medicare payments, and the eventual shift in paradigm to reimbursement based on patient outcomes. This sea change threatens the traditional brick and mortar construct […]
One question I encounter frequently is, “Why should I try to maximize my CDM when no one pays me based on it?” It may seem this way because of the change in health care the past few years, yet a competitive CDM is crucial as we move towards pricing transparency. CMS has posted hospital prices […]
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